Vitamin D Analogs (Includes Calcifediol) ↔ Electrolyte Imbalance

Severe Potential Hazard, High plausibility

Applies to: Phosphate Imbalance

Vitamin D analogs administered in the presence of hyperphosphatemia can result in precipitation of calcium-phosphate deposits within the vascular or renal systems or other soft tissue calcifications. A solubility product (Serum Calcium X Phosphate) should not exceed 70. Serum electrolyte concentrations should be corrected prior to vitamin D analog therapy and monitored during therapy.

Vitamin D Analogs (Includes Calcifediol) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: hemodialysis, Renal Dysfunction

Ergocalciferol, cholecalciferol, and calcifediol undergo renal biotransformation during metabolic activation. Renal impairment can alter metabolic and therapeutic activity of certain vitamin D analogs. Alternative vitamin D analogs such as dihydrotachysterol (hepatic activation) and calcitriol (active form) may be considered in patients with compromised renal function. However, calcitriol increases inorganic phosphate levels in serum, which is desirable in patients with hypophosphatemia. but cautious should be used in patients with renal failure because of a danger of ectopic calcification.

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